NPI | 1164882874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: TN 35657) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: CA 95028558) |
363LN0000X Nurse Practitioner, Neonatal (Licence: TX AP130587) | |
163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TX 796789) | |
Enumeration Date | 2016-02-24 |
Last Update Date | 2025-07-23 |